| NPI | 1225368335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 938082) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2018-02-07 |